• Laura J Faherty, Adam J Rose, Andre Chappel, Caroline Taplin, Monique Martineau, and Shira H Fischer.
• RAND Corporation, Boston, MA, USA. lfaherty@rand.org.
• J Gen Intern Med. 2020 Mar 1; 35 (3): 899-902.

BackgroundIn 2003, Project ECHO (Extension for Community Healthcare Outcomes) began using technology-enabled collaborative models of care to help general practitioners in rural settings manage hepatitis C. Today, ECHO and ECHO-like models (EELM) have been applied to a variety of settings and health conditions, but the evidence base underlying EELM is thin, despite widespread enthusiasm for the model.MethodsIn April 2018, a technical expert panel (TEP) meeting was convened to assess the current evidence base for EELM and identify ways to strengthen it.ResultsTEP members identified four strategies for future implementors and evaluators of EELM to address key challenges to conducting rigorous evaluations: (1) develop a clear understanding of EELM and what they are intended to accomplish; (2) emphasize rigorous reporting of EELM program characteristics; (3) use a wider variety of study designs to fill key knowledge gaps about EELM; (4) address structural barriers through capacity building and stakeholder engagement.ConclusionsBuilding a strong evidence base will help leverage the innovative aspects of EELM by better understanding how, why, and in what contexts EELM improve care access, quality, and delivery, while also improving provider satisfaction and capacity.

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